Publications by authors named "Leyla Sahebi"

24 Publications

  • Page 1 of 1

Olfactory Dysfunction is Associated with More Severe Clinical Course in COVID-19.

Indian J Otolaryngol Head Neck Surg 2021 Mar 12:1-6. Epub 2021 Mar 12.

Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran.

To perform a quantitative olfactory test in positive COVID19 RT-PCR admitted patients and asymptomatic ones, to evaluate the association between hyposmia and disease severity. This is a Cross sectional study. Ninety-one patients including 68 inpatients and 23 asymptomatic healthcare workers with positive COVID-19 RT-PCRs. Methods: Demographics and clinical characteristics were collected. Iran Smell Identification Test (IR-SIT), a highly accurate 6-odorant test was used to evaluate the reliability of self-reported hyposmia and determine the correlation of the measured olfactory dysfunction with disease severity. Twenty-two of 91 patients (24%) reported hyposmia, while 41/91 (45%) patients had measurable olfactory dysfunction (IR-SIT score 1-4,  < 0.05). Mean age of the 68 inpatients and 23 asymptomatic patients were 43.97 ± 16.13 years; M:F 43:25, and 43.87 ± 12.76 years; M:F 8:15 respectively. Of 68 patients, 20 were graded as severe, and 48/68 had mild course of disease. IR-SIT detected hyposmia in 80% of patients with severe disease, and 50% with mild disease, respectively. The risk of disease severity was significantly increased for patients with olfactory dysfunction and was detected 4 times higher when compared to patients with mild disease (OR 4, 95% CI: 1.166-13.728,  = 0.028). Olfactory Dysfunction was present in 80% of patients with severe course. The risk of disease severity is significantly increased with olfactory dysfunction in admitted patients.
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http://dx.doi.org/10.1007/s12070-021-02507-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954203PMC
March 2021

Fractional CO2 Laser for Treatment of Vulvovaginal Atrophy: A Short Time Follow-up.

J Family Reprod Health 2020 Jun;14(2):68-73

Department of Obstetrics & Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

The aim of this study was to evaluate the safety and efficacy of fractional CO2 laser for treatment of vulvovaginal atrophy. In this clinical trial study, we evaluated the laser effect on vulvovaginal atrophy in 47 women aged 43-80 years. Each woman was treated with fractional CO2 laser, SmartXide2V2LR, DEKA, Monalisa Touch, vaginal 360o probe and cosmetic probe. The severity of vulvovaginal atrophy symptoms was evaluated before first session of laser and every 4 weeks after laser treatment until 12 weeks. Adverse effects including pain and itching were assessed at all visits. The statistical analysis was performed using SPSS version 23. The response to laser therapy for vaginal dryness was significantly (p <0.001) improved. Also, the response to laser therapy for each symptom include dyspareunia, vaginal discharge, itching and urge urinary incontinence was statistically significant (p <0.001) based on visual analogue scale (VAS). It seems vaginal fractional CO2 laser can be applied as an effective and safe treatment method in genitourinary syndrome of menopause (GSM). It is necessary to conduct studies with long-term follow-up.
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http://dx.doi.org/10.18502/jfrh.v14i2.4347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865202PMC
June 2020

Validity and Reliability of Persian Version of 12-Item Pruritus Severity Score Questionnaire in Patients with Chronic Liver Disease and Pruritus.

Middle East J Dig Dis 2020 Oct;12(4):278-283

PharmD, Clinical Pharmacist, Professor, Clinical Pharmacy Department, school of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

BACKGROUND Currently, there is no published questionnaire translated in the Persian language for pruritus evaluation in patients with chronic liver disease. Therefore, it would be well worth having a valid and reliable Persian questionnaire for assessing pruritus with its different aspects. This study was designed to evaluate the validity and reliability of the translated version of the 12-Item Pruritus Severity Score (12-PSS) METHODS The patients with pruritus due to chronic liver disease, who referred to the liver clinic affiliated to Tehran University of Medical Sciences, were enrolled in this cross-sectional study. Following the forward-backward translation of 12-PSS into Persian, the content validity index (CVI) and its reliability were assessed. The patients were asked to respond to the visual analog scale (VAS) along with 12-PSS on their visits to evaluate the correlation between them. RESULTS 160 eligible patients were entered in the present study. The mean age was 46.03 (±13.05) years. The Cronbach's alpha for all domains of 12-PSS was 0.81-0.92 (average 0.89), which showed a strong consistency. The mean VAS and 12-PSS were 5.47±2.55 and 11.71 ± 5.25, respectively, and the correlation of VAS and 12-PSS was strong ( < 0.05, r = 0.89). CONCLUSION The Persian version of 12-PSS is a valid questionnaire for assessing pruritus and follow up response to treatment for patients with chronic liver disease.
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http://dx.doi.org/10.34172/mejdd.2020.194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859607PMC
October 2020

Relationship of Loneliness and Social Isolation With Self-Care Ability Among Older Adults.

J Psychosoc Nurs Ment Health Serv 2021 Jan;59(1):15-20

The current study aimed to assess the relationship of loneliness and social isolation with self-care ability (SCA) among older adults. Participants were 170 older adults randomly recruited from seven urban health care centers in Gonbad Kavus, Iran. Data were collected using a personal characteristics questionnaire, the UCLA Loneliness Scale, Lubben Social Network Scale, and Self-Care Ability Questionnaire for the Elderly. Findings showed that 72.9% of participants reported mild loneliness and 2.4% reported severe loneliness. Mean scores of participants' loneliness, social isolation, and SCA were 29.91 (SD = 11.22), 18.57 (SD = 4.97), and 146.39 (SD = 7.62), respectively. Mean SCA score had a significant inverse relationship with mean loneliness score (β = -0.368; p < 0.0001) and a significant direct relationship with mean social isolation score (β = 0.726; p < 0.0001). Current findings can be used to develop interventions for reducing loneliness and social isolation and improving SCA among older adults. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 15-20.].
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http://dx.doi.org/10.3928/02793695-20201210-04DOI Listing
January 2021

Internal Jugular Vein Thrombosis Following Different Types of Neck Dissection.

Iran J Otorhinolaryngol 2020 Nov;32(113):343-347

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: During functional neck dissection, the surgeon tries to preserve the internal jugular vein (IJV); however, the incidence of its narrowing or obstruction following modified radical neck dissection (MRND) or selective neck dissection (SND) varies between 0% and 29.6%. The most distressing complication of IJV thrombosis (IJVT) is pulmonary embolism. This study aimed to evaluate the incidence of IJVT following selective or modified radical neck dissection.

Materials And Methods: In this study, 109 neck dissections were performed with the preservation of the IJV on 89 patients from March 2011 to December 2012 in the Cancer Institute of Imam Khomeini Hospital Complex, Tehran, Iran. Ultrasound evaluation of the IJV was performed in the early postoperative period and three months after the surgery.

Results: The study population consisted of 62 male and 27 female patients with a mean age of 57+17.57 years. Ultrasound evaluation of the IJV among the participants (109 veins) indicated thrombosis in nine veins (8.25%) in the early postoperative period, four of which remained thrombotic and without flow three months after the surgery. Moreover, 96.33% of the IJVs were patent with a normal blood flow three months after the neck dissection. Among the evaluated IJVs, the only factor that showed a significant association with IJVT was the incidence of postoperative complications, including hematoma and seroma (P=0.01).

Conclusion: It seems that the most important factor for the prevention of the IJVT is a meticulous surgery and surgical complication avoidance during neck dissection.
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http://dx.doi.org/10.22038/ijorl.2020.25549.1839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701489PMC
November 2020

Duration of Breastfeeding and Maternal-Related Factors in Iran, Systematic Review and Meta-Analysis.

J Pediatr Nurs 2020 Sep - Oct;54:e23-e30. Epub 2020 Jun 15.

Family Health Research Institute, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran. Electronic address:

Background: Although the benefits of breastfeeding are commonly approved, there remains a significant discrepancy between maternal practices and World Health Organization (WHO) guidelines in some countries.

Objectives: We had two aims in this study; average duration of breastfeeding, and its maternal determinants.

Data Sources: A web-based citation index was used for citing documents.

Study Eligibility Criteria And Participants: We included observational studies evaluating breastfeeding duration among children who were at least two years old and not older than five were included in Iran.

Synthesis Methods: The pooled mean and mean differences were considered. Heterogeneity was evaluated with the I statistic.

Results: The pooled mean of breastfeeding duration was calculated at 17.31 months. Children with younger mothers and lower birth orders had shorter durations of breastfeeding. Women with a high school and higher education level had early cessation of breastfeeding in comparison with less educated women.

Limitations: The main limitation of the current study was lack of librarian assistance.

Conclusions: The pooled mean of breastfeeding duration in Iranian children aged 2-5 was less than WHO recommendations. Accurate identification of the effect a mother's level of education has on duration of lactation requires standardized categorization.

Implications Of Key Findings: Raising awareness among women can be an effective strategy in increasing the duration of lactation.
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http://dx.doi.org/10.1016/j.pedn.2020.04.011DOI Listing
April 2021

Effectiveness of bacillus Calmette-Guerin vaccination history on pulmonary tuberculosis symptoms.

J Clin Tuberc Other Mycobact Dis 2019 Dec 19;17:100126. Epub 2019 Sep 19.

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Science, Tabriz, Iran.

Introduction: The aim of this study was to explore the effectiveness of BCG vaccination on the severity of clinical symptoms of pulmonary tuberculosis symptoms PTb) in patients from the northwest and west of Iran.

Materials And Methods: In a cross sectional study of 358 patients with a diagnosis of PTb, 11 clinical symptoms, including cough, chest pain, dyspnea, sputum, fever, hemoptysis, weight loss, loss of appetite, wheezing, weakness, and fatigue were checked and patients with a score of six or more were placed in the severe clinical symptoms group. BCG vaccination scar and clinical symptoms were examined and recorded.

Results: Of the subjects included in this study, 264 cases (73.7%) had no BCG vaccination scar. Comparison of the severity of clinical symptoms of PTb in patients with BCG vaccine history to those lacking vaccination history revealed lower symptom severity in patients who had been vaccinated (vaccine effectiveness = 95.5%;  < 0.00001).

Conclusion: The results of this study may imply that Adjusting for age sex and smoking status, BCG vaccination decreases the severity of clinical symptoms in patients with PTb. We suggest performing a retrospective cohort study on a larger population.
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http://dx.doi.org/10.1016/j.jctube.2019.100126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879972PMC
December 2019

Iranian neonatal diabetes mellitus due to mutation in PDX1 gene: a case report.

J Med Case Rep 2019 Aug 1;13(1):258. Epub 2019 Aug 1.

Institute of Family Health, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran.

Background: Neonatal diabetes mellitus with hyperglycemia during the first 6 months of life is a rare disorder that can occur in all races and societies.

Case Presentation: In this study, we introduced an Iranian (Persian) 65-day-old patient with neonatal diabetes mellitus with novel homozygous mutation in the pancreatic and duodenal homeobox 1, PDX1, gene, which is also known as IPF1 gene, located in exon 2. This case was a newborn boy born in Vali-Asr Hospital, Tehran; he was diagnosed as having hyperglycemia on 28th day. Genetic analysis detected a homozygous mutation on PDX1 gene on chromosome 13. It is a novel homozygous mutation in the PDX1 gene (NM_000209.3), p.Phe167Val. This mutation was confirmed by Sanger sequencing. There was no evidence of agenesis of the pancreas.

Conclusions: We reported a case of neonatal diabetes mellitus due to novel homozygous mutation in the PDX1 gene without exocrine pancreas manifestations.
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http://dx.doi.org/10.1186/s13256-019-2149-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670147PMC
August 2019

Tuberculosis and Diabetes Mellitus in Northwest of Iran.

Infect Disord Drug Targets 2020 ;20(5):667-671

Biotechnology Research Center, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Planning for control of tuberculosis would need to screen and identify individuals susceptible to TB. Due to the weakness of immune system in diabetic patients, it is more likely for them to reactivate latent TB infection. Regarding the increasing number of diabetics in the community, in this study efforts have been made to estimate the frequency of individuals who have tuberculosis and diabetes mellitus (TB-DM) simultaneously, as it could help making preventive decisions to reduce TB in this part of Iran.

Materials And Methods: In this study, 329 cases of confirmed TB patients were divided into two groups of diabetic and non-diabetic, then demographic information and clinical variables have been compared between the two groups.

Results: Among the examined subjects, 47 patients (14.29 %) had suffered from diabetes mellitus and tuberculosis. All of the DM patients had pulmonary tuberculosis and 87.23% of them were over the age of 50.

Conclusion: Majority of DM-TB patients were over 50 years of age and also more than half of them were women. So it seems that for DM women over the age of 50, to detect tuberculosis, screening tests such as PPD may be necessary.
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http://dx.doi.org/10.2174/1871526519666190715142100DOI Listing
January 2020

Exclusive Breastfeeding Duration and its Effect on the Health of the Children in Iran, a Meta Analysis.

J Pediatr Nurs 2019 Sep - Oct;48:e8-e14. Epub 2019 May 25.

Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran. Electronic address:

Problem: Given the importance of exclusive breastfeeding (EB) duration on growth and to maintain health in children, we decided to systematically review the existing research on EB duration and its effect on the health of 2- to 5-year-old children in Iran.

Eligibility Criteria: A systematic literature search was conducted in the Database of Abstracts of Reviews of Effects (DARE), Google Scholar, PubMed, Psyc INFO, Thomson Reuters, Cochrane, and Medical Library (MedLib) to detect appropriate studies (1994 to 2016). Outcomes of mean, mean difference, and proportions were pooled.

Sample: In this meta-analysis, 38 studies met the eligibility criteria.

Results: The pooled mean of EB was calculated as 4.1 months (CI 95%: 3.2, 4.99). The meta prevalence of EB up to 4 months and 5 to 6 months was estimated 65.0% (CI 95%: 54.0, 77.0) and 54% (CI 95%: 46.0, 62.0) respectively. Based on studies conducted over the years from 1994 to 2016, an increasing trend of EB was found in infants up to 4 months (p ≤ 0.0001). Among children with anemia and respiratory diseases EB until 5 to 6 months was more common than in healthy children (CI 95%; 1.1, 2.11, and 1.01, 1.47 respectively).

Conclusion: The duration of EB (4.1 months) was equal to the lower limit recommended by the World Health Organization (WHO). Overall, the duration of EB until 5 to 6 months is sufficient if the child's iron intake is well-monitored.

Implication: Monitoring of the implementation of recent guidelines or even modification of the duration period of the iron administration is potentially necessary.
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http://dx.doi.org/10.1016/j.pedn.2019.04.030DOI Listing
May 2020

Relationship Among HIV-Related Stigma, Mental Health and Quality of life for HIV-Positive Patients in Tehran.

AIDS Behav 2018 Dec;22(12):3773-3782

Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran.

People living with HIV/AIDS (PLHA) face several challenges in terms of the medical management of their disease. Alongside this are stigma, discrimination and psychosocial issues associated with HIV infection. In this study, the relationships associated with HIV-related stigma, mental health and quality of life for HIV-positive patients were investigated. This cross-sectional study examined a sample of 450 HIV positive patients from the Infectious Diseases and Behavioral Health Clinic of Imam Khomeini Hospital in the city of Tehran, Iran. PLWHA completed Socio-Demographic Characteristics, Berger Scale Stigma (BSS), General Health Questionnaire (GHQ-28), WHO Quality of life-BREF (WHOQOL-BREF) and Philips Social Support Appraisals (SSA). Stigma was significantly correlated with psychological variables, social support, and quality of life. A prevalence of psychiatric disorders was reported by 78.8%. Findings suggested that psychosocial interventions reduce HIV related stigma, address psychological disorders and build social support to improve quality of life for people living with HIV.
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http://dx.doi.org/10.1007/s10461-017-2023-zDOI Listing
December 2018

Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial.

Eur Arch Otorhinolaryngol 2018 Jan 17;275(1):89-97. Epub 2017 Nov 17.

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: The present study was conducted to compare the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies.

Study Design: Triple-blind randomized clinical trial.

Settings: Tertiary referral hospital.

Subjects And Methods: A total of 112 patients who were admitted to the ENT emergency department randomly divided into three groups: an oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with antiviral and proton pomp inhibitor. An audiometry was performed once before beginning the therapies and again at the end of the therapy.

Results: Of the total of 112 patients, 32 received intratympanic (IT) corticosteroids, 45 were receiving systemic corticosteroids, and 35 were receiving a combination of the two. A total of 74 patients (66.1%) responded positively [response to treatment was calculated as gain of at least 10 dB in 10 dB in average threshold or with the minimum improvement of 15% in speech discrimination scores (SDS)] to corticosteroid therapy. No significant differences were observed between the three groups (IT, systemic group, and combination therapy group) in their overall response to treatment (p = 0.5). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (p < 0.002). Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (p < 0.001). The response to treatment was not related to the pattern (p = 0.04) and initial severity of hearing loss (p = 0.9).

Conclusion: This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss.

Level Of Evidence: 1b.
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http://dx.doi.org/10.1007/s00405-017-4808-0DOI Listing
January 2018

Mycobacterium tuberculosis of the Beijing Genotype in Iran and the World Health Organization Eastern Mediterranean Region: A Meta-Analysis.

Microb Drug Resist 2018 Jul/Aug;24(6):693-698. Epub 2017 Oct 23.

6 Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences , Kermanshah, Iran .

Objective: The Beijing genotype is a distinct genetic lineage of Mycobacterium tuberculosis, which is distributed worldwide, and may cause large outbreaks of multidrug resistance-tuberculosis (MDR-TB). The distribution of such strains in the Eastern Mediterranean region (EMR) is unclear, and clarifying the data is our purpose apart from the presence of Beijing TB in Iran.

Methods: We searched Published literature from CINAHL Cochrane Library, Current Contents, Database of Abstracts of Reviews of Effects (DARE), ProQuest Google Scholar PubMed, PsycINFO, Thomson Reuters, (SID), and Medical Library (MedLib) to detect relevant studies from the year 2000 to July 2015 with the following keywords: M. tuberculosis, Beijing genotype, EMR, and drug resistance. Random-effect models were used to estimate the proportion of Beijing strains in STATA 14. Heterogeneity was investigated by subgroup analysis and meta-regression.

Results And Conclusion: The meta-prevalence of Beijing strains was 4% (CI 95% = 3-5). The prevalence was different based on types of detection techniques (spoligotyping = 4% vs. other techniques = 6%; p = 0.003) and years of study (before the year 2000 = 2% vs. after year 2000 = 4%, p = 0.004). The Beijing family was most prevalent in Iran and Pakistan. A strong relationship with drug resistance was reported in Pakistan and Iran, and an increasing trend was seen in Pakistan. Additional studies of drug-resistant TB distribution among Beijing strains in EMR countries are needed as well as a time-trend analysis of the Beijing strain infection in the region.
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http://dx.doi.org/10.1089/mdr.2017.0160DOI Listing
October 2018

Beijing strains of in smear-positive tuberculosis patients in North-West and West of Iran.

Adv Biomed Res 2016 28;5:181. Epub 2016 Nov 28.

Department of Plant Breeding and Biotechnology, School of Agriculture, University of Tabriz, Tabriz, Iran.

Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases. The goal of this cross-sectional study (2012-2014) was to examine the prevalence of TB (MTB) Beijing strains in regions near the Iranian border and to identify any epidemiological links.

Materials And Methods: To this end, MTB isolates were harvested, from 64 HIV-negative, pulmonary smear-positive TB patients from the Iranian border provinces of East Azerbaijan (North-West), Kurdistan (West), and Kermanshah (West) (2012-2014). Isolates were subjected to restriction fragment length polymorphism (RFLP) analysis, using the insertion sequence IS6110 as a probe (IS6110 RFLP), and drug susceptibility testing by the proportion method. We gathered demographic and clinical data using a questionnaire and reviewing patient records. Results were analyzed with Gel Compare II 6.6 and SPSS-18.

Results: The mean age of the patients was 54.4 years and 46.9% were male. The prevalence of Beijing strains among the isolates was 9.4% (17.6% in the Western provinces and 0% in East Azerbaijan). There was a statistically significant relationship between the Beijing strains and drug resistance and also between these strains, and the recurrence of TB in patients that had previously received treatment ( = 0.02 and = 0.04, respectively).

Conclusions: Finally, the prevalence of Beijing strains in Western Iran was greater than expected. Our results therefore indicate that regional and cross-border tracing may be necessary to control spread of this organism.
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http://dx.doi.org/10.4103/2277-9175.190982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5157006PMC
November 2016

Rapid Detection of Rifampicin- and Isoniazid-Resistant Using Real-Time PCR.

Jundishapur J Microbiol 2016 Oct 16;9(10):e29147. Epub 2016 Apr 16.

Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.

Background: Accurate and rapid detection of drug-resistant is fundamental for the successful treatment of tuberculosis (TB).

Objectives: The aim of this study was to determine the frequency of common mutations leading to isoniazid (INH) and rifampicin (RMP) resistance.

Patients And Methods: In a cross-sectional study carried out in 2014, 90 patients with from five border provinces of Iran were selected. After a full clinical history and physical evaluation, real-time polymerase chain reaction (PCR) technique was performed for the detection of mutations in the patients' and genes. The results were compared with results of a standard proportion method as well as a multiplex allele-specific PCR (MAS-PCR).

Results: A total of 23 mutations were found in isolates among which, codon 315 P1 (511 - 519 sequence) and P2 (524-533 sequence) were responsible for seven, nine and seven cases, respectively. The mean (standard deviation (SD)) of melting temperature (Tm) in 315 codon, P1 and P2 sequences in susceptible and mutant isolates was as follows: 85.4°C (0.18) and 87.54°C (0.62); P1 84.6°C (0.61) and 82.9°C (0.38); P2 83.4°C (0.18) and 85.3°C (0.19), respectively. In comparison to the standard proportion test, the sensitivity of real-time PCR in detecting INH- and RMP-resistant mutations was 75% and 83.3%, respectively. In comparison to the MAS-PCR test, 100% of 315 mutations and 80% of mutations were determined. Overall, 10% of the patients were diagnosed with a recurrence of TB. Age and previous history of TB treatment increased mutation odds in sequences (P = 0.046, P = 0.036, respectively).

Conclusions: Detection of drug resistance associated with mutations through real-time PCR by melting analysis technique showed a high differentiating power. This technique had high concordance with the standard proportion test and MAS-PCR results.
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http://dx.doi.org/10.5812/jjm.29147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5136450PMC
October 2016

Patterns of Drug Resistance Among Tuberculosis Patients in West and Northwestern Iran.

Open Respir Med J 2016 30;10:29-35. Epub 2016 Jun 30.

Health Center of East Azerbaijan Province, Tabriz University of Medical Science, Tabriz, Iran.

Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases.

Objective: The goal of this cross-sectional study (2011-2013;2013) was to examine the patterns of TB drug resistance among HIV-negative pulmonary TB patients in regions near the Iranian border.

Method: To this end, MTB isolates were harvested from 300 HIV-negative, pulmonary smear-positive TB patients from the northwest and west Iranian border provinces. Isolates were subjected to first and second-line drug susceptibility testing by the 1% proportion method. Demographic and clinical data were provided using a questionnaire and information from patient records. Results were analyzed using SPSS-18.

Results: The mean age of the patients was 52.03 years and 54.3% were male. The prevalence of resistance to any TB drug was 13.6% (38 cases). Eleven percent of the new treatment TB group (28 patients) and 40.7% of the retreatment TB group (11 patients) were resistant to all TB drugs. Twelve (4.3%) patients had multidrug-resistant tuberculosis (MDR-TB) (2.38% in the new TB treatment group and 23.1% in the retreatment group). One patient had extensively drug-resistant tuberculosis (XDR-TB). There was a statistically significant relationship between TB drug resistance and smoking (p=0.02) and a history of migration from village to city (p=0.04), also between TB drug resistance and recurrence of TB in patients that had previously received treatment (p<0.001).

Conclusion: Knowledge of drug resistance patterns for new and previously treated cases is critical for effective control of MDR-TB in different regions of the country. The burden of MDR-TB in retreatment cases was high. Previous TB treatment was one of the most important mokers and those who had a history of rural to urban migration were at high risk for the occurrence of TB drug resistance.
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http://dx.doi.org/10.2174/1874306401610010029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992749PMC
September 2016

Relationship Between Psychiatric Distress and Criminal History Among Intravenous Drug Abusers in Iran.

Iran J Psychiatry Behav Sci 2015 Jun 23;9(2):e838. Epub 2015 Jun 23.

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.

Background: Sychotropic agents (alcohol, drugs, and illicit substances) have an important effect on the occurrence or exacerbation of psychological and behavioral derangements such as criminal activity and mental abnormalities.

Objectives: The objective was to assess the relationship between psychiatric distress and criminal history among abusers of intravenous drugs, including heroin, benzodiazepine, codeine, cannabis, opium, and ecstasy.

Materials And Methods: Criminal activity history and psychiatric distress were evaluated among intravenous drug abusers in drop-in centers (DIC) (141 subjects) and an outpatient service to delivery methadone to the addicts located in Razy Hospital (Baghdad, Iraq) (120 subjects). Logistic regression analyses using the SPSS for Windows 18.0 were used for analyzing the data.

Results: About 86% of the intravenous drug abusers had psychiatric distress and 48.2% had criminal activity history. DIC addicts group had a better mental well-being compared to the other group, but criminal history rate was similar in two groups. In multiple logistic regression, addiction to heroin (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.1 - 4.1), mental disorders (β = 0.060, P = 0.026), and low level of education was highly related with criminal activity (OR = 0.17, 95% CI: 0.03 - 0.89).

Conclusions: Higher scores in mental well-being questionnaire of DIC addicts suggest the positive effects of psychological interventions. There is a possibility of the involvement of heroin in occurrence of mental disorders and criminal activity. This finding needs further investigations by larger cohort studies.
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http://dx.doi.org/10.17795/ijpbs838DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539586PMC
June 2015

Prevalence and risk factors of drug-resistant tuberculosis in border provinces of Iran.

Postgrad Med 2015 Aug 15;127(6):600-6. Epub 2015 Jul 15.

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Science , Tabriz , Iran.

Objective: Rapid detection of mycobacterium tuberculosis (MTB) resistance is a key step in the control of disease. This study aimed to identify the prevalence and accuracy of isoniazid (INH) and rifampin (RMP) resistance and their risk factors using multiplex allele-specific polymerase chain reaction (MAS-PCR) to detect such mutations.

Materials And Methods: In this cross-sectional study (2012-2013), 257 MTB patients from five frontier border provinces of Iran were selected and after divulging a full clinical history and undergoing a physical evaluation, the accuracy of drug resistance detection was carried out using the standard proportion test, sequencing, and GeneXpert/rifampicin (RIF) technique. Full demographic and environmental histories were evaluated.

Results: The overall frequency of mutations was 34. Frequency of patients with mutations in KatG315 and at least one rpoB codon (of 516, 526, and 531 codons) were seven cases (2.7%). In comparison to the standard proportion test, the sensitivity and specificity of MAS-PCR in detecting common INH-resistant mutations were 68.75 and 100%, and in the detection of common RMP-resistant mutation were 81.8 and 100%, respectively. Also, 88.89% of KatG 315 mutations and 100% of rpoB mutations were diagnosed and compared with DNA sequencings. Compared to GeneXpert/RIF, 100% of RMP common point mutation was determined by MAS-PCR. Mutation odds were higher in males and greater in those with a history of anti-tuberculosis treatment.

Conclusion: The results of this study indicated that MAS-PCR is an efficient method for rapid detection of mutations leading to RMP resistance but merely to KatG it is not satisfactory for the detection of INH resistance. Accurate and rapid detection of drug resistance is crucial in males and patients with a history of tuberculosis.
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http://dx.doi.org/10.1080/00325481.2015.1069168DOI Listing
August 2015

The factors associated with tuberculosis recurrence in the northwest and west of iran.

Malays J Med Sci 2014 Nov-Dec;21(6):27-35

Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Science Daneshgah Street, Postal code 51665118, Tabriz, Iran.

Background: Identifying the factors associated with the recurrence of Mycobacterium tuberculosis (MTB) can help in tuberculosis disease prevention and reducing the burden on the health care system. This study was designed to identify the factors associated with recurrence in MTB patients in five border provinces of Iran.

Methods: In a cross-sectional study (2010 to 2012), clinical, economic, and social factors associated with the recurrence of tuberculosis were evaluated. The data were collected by a questionnaire and survey of medical records. Simple and multiple logistic regression analyses were performed using SPSS V.18.

Results: A total of 300 patients with an average age of 51.9 years (SD 24.2) were randomly selected. Overall, 7.2% of the patients were diagnosed with a recurrence of tuberculosis. Sixty-four percent (n = 151) of the patients were in a low-income class. The migration from a village to a city (OR = 8.4) and weight loss (OR = 1.5) were significantly associated with an increased chance of recurrence.

Conclusion: In this study, the selected provinces of Iran had moderate rates of tuberculosis recurrence in comparison to global reports. Further studies on the relationship of both weight loss and the immigration from a village to a city with tuberculosis recurrence are necessary.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391452PMC
April 2015

Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: a randomized clinical trial.

J Cardiovasc Thorac Res 2015 29;7(1):13-7. Epub 2015 Mar 29.

Tabriz Health Service Management Research Center, National public health management center (NPMC), Tabriz University of Medical Sciences, Tabriz, Iran.

Introduction: Prevention of pulmonary complications after coronary artery bypass graft is attended as a very important issue. The aim of this study was to evaluate the role of pulmonary rehabilitation before surgery for reducing the risk of pulmonary complications after surgery.

Methods: In a randomized clinical trial, 60 patients undergoing heart surgery were randomly divided into two groups A and B. Chest physiotherapy was performed before and after surgery on group A patients however it was done on group B's, only after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and arterial blood gas (ABG).

Results: Thirty nine males (65%) and 21 females (35%) with mean age of 8.10 ± 9.56 were analyzed. The mean differences were statistically significant for predicted forced vital capacity (FVC) (CI 95%:1.3 to 8.7) and Predicted Peak Flow indices (PEF) (CI 95%: 1.9 to 9.4) of spirometry indicator, PCO2 index (of ABG parameter) (CI 95%: 1.4 to 8.9) and mean oxygen saturation (mean Spo2) (CI 95%: 0.6 to 1.7) of ABG index in two groups.

Conclusion: The performance of pulmonary rehabilitation program before surgery is recommended, as it may result in the reduction of complications of heart surgery.
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http://dx.doi.org/10.15171/jcvtr.2015.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378669PMC
April 2015

Vitamin d receptor gene polymorphism and vitamin d plasma concentration: correlation with susceptibility to tuberculosis.

Adv Pharm Bull 2014 Dec 31;4(Suppl 2):607-11. Epub 2014 Dec 31.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. ; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Purpose: It is estimated that one third of the world's population were infected with M. tuberculosis, but only 10% of them have developed in to disease form. This subject refers to differences in host immune system activity against the tuberculosis. Vitamin D and its receptor (VDR) are important factors in the host innate immune system against the tuberculosis. In the present study VDR gene polymorphisms and its relationship with plasma vitamin D levels in susceptibility to tuberculosis have been investigated.

Methods: The subjects were 84 patients with tuberculosis and 90 healthy controls. Vitamin D levels were measured in all study participants. DNA was isolated from the blood leukocytes of all groups and amplified by polymerase chain reaction (PCR). Then restriction fragment length polymorphism (RFLP) was performed on each PCR products to study the VDR gene polymorphisms. The statistical analyses were conducted using SPSS.

Results: There was no statistically significant relationship between polymorphisms of FokI, BsmI, ApaI and TaqI in VDR gene and susceptibility to tuberculosis. Vitamin D deficiency and susceptibility to tuberculosis were closely related (95% CI -0.08 - 4.7, P = 0.059). Also the relationship between plasma vitamin D levels and frequency of FokI-ff gene polymorphism was significant in all study participants (P = 0.045).

Conclusion: When the genotype frequencies of VDR gene polymorphisms were analyzed with respect to plasma vitamin D levels, a significant association was seen. As an enhancement in plasma vitamin D levels in individuals (with FokI-ff genotype and low levels of vitamin D) may protect them against active tuberculosis.
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http://dx.doi.org/10.5681/apb.2014.089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312412PMC
December 2014

Genetic Variations of Tumor Necrosis Factor -α-308 and Lymphtoxin-α+252 in Non-Hodgkin Lymphoma and Acute Lymphoblastic Leukemia Patients.

Iran J Basic Med Sci 2013 Sep;16(9):990-5

School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective(s): Non- Hodgkin lymphoma (NHL) and acute lymphoblastic leukemia (ALL) are two main hematological malignances which have been driven from lymphoid tissue. Genetic polymorphisms in tumor necrosis factor-α (TNF-α) -308 and lymphotoxin-α (LT-α) +252 may affect their transcription and expression which leads to their high plasma level. The frequency of the TNF-α (-308) and LT-α (+ 252) polymorphisms are different for NHL and ALL cases in various populations with different ethnicity. This research is designed to investigate the prevalence and association of TNF-α (-308) and LT-α (+ 252) polymorphisms from NHL and ALL in Azarian patients and healthy individuals from Northwestern part of Iran.

Materials And Methods: Seventy subjects with ALL and 68 NHL, along with another 130 healthy subjects as control group took part in this study. Genomic DNA was extracted, then genetic polymorphisms in TNF-α and LT-α genes were analyzed with the PCR-RFLP and NCOI as restriction enzyme. A statistical analysis was performed by chi-square test using SPSS software. A P-value of <0.05 was considered statistically significant.

Results: A statistically significant difference of LT-α polymorphism was in NHL patients and control (P-value= 0.008) but there was not any association of TNF-α polymorphism between NHL patients and control group. A significant association for TNF-a variant was in ALL and control (P-value =0.005), however, there was no relationship about LT variant between ALL and control.

Conclusion: The results show that there are significant differences between TNF-α (-308) and LT-α (+252) genetic polymorphisms respectively in ALL and NHL patients with control group from Northwestern part of Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804848PMC
September 2013

Obstructive sleep apnea syndrome: complaints and housing characteristics in a population in the United States.

Sao Paulo Med J 2013 ;131(4):220-7

Pulmonologist and Chairman of Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

CONTEXT AND OBJECTIVE Obstructive sleep apnea syndrome (OSAS) is one of the leading causes of morbidity and mortality in adults. Early detection of the disorder and discovery of risk factors through standardized questionnaires will lead to reduction of the OSAS burden. The main aim of this study was to estimate the prevalence of OSAS symptoms and examine their association with housing characteristics. DESIGN AND SETTING Cross-sectional study at a medical school. METHODS Demographic, housing and body measurement data on 5,545 individuals aged 16 years and over of various races were selected from the National Health and Nutrition Examination Survey. We analyzed the probability of OSAS based on habitual snoring combined with daytime sleepiness and/or witnessed apnea. Univariate and multiple linear regression were used. RESULTS 9.8% of the men and 6.9% of the women reported symptoms suggestive of OSAS (habitual snoring, daytime sleepiness and/or apnea). The following prevalences of symptoms were found among males and females respectively: frequent snoring 35.1%, 22.3%, excessive daytime sleepiness 6.4%, 3.4% and frequent apnea 14.9%, 20.6%. Using multiple linear regression, OSAS symptoms were correlated with gender, age, body mass index (BMI), marital status and education. Regarding housing characteristics, mildew or musty smell and pets in the environment were associated with a high probability of OSAS. CONCLUSION OSAS symptoms were more prevalent than in developing countries. The environment was an important risk factor, but environmental factors are easier to control and manage than other variables like BMI or socioeconomic status.
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http://dx.doi.org/10.1590/1516-3180.2013.1314451DOI Listing
May 2014

Self-medication and storage of drugs at home among the clients of drugstores in Tabriz.

Curr Drug Saf 2009 May;4(2):107-12

Department of Public Health, National Public Health Management Center (NPMC), Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: This study was conducted with four objectives in mind, including: (1) characteristics of self-medication; (2) storage of drugs at home; (3) factors associated with storage of drugs at home; and (4) comparison of the level and sources of knowledge between over-the-counter (OTC) and prescription-only (POM) medication consumers.

Methods: A cross-sectional survey was conducted in 2007 using a semi-structured questionnaire on 300 clients of 21 drugstores (from a total of 214 drugstores in the city of Tabriz, Iran).

Results: The highest demand for drugs was for analgesics (from OTC drugs) and antibiotics (from POM drugs). Of 325 requests for medications by 300 customers of drugstores in Tabriz, aged 15 years or higher, 50.8% (165 requests) were for OTC drugs and 49.2% (160 requests) were for POM drugs, twenty-five cases requested both OTC and POM medications. There were 246 customers (82%) who reported that they stored drugs at home. Physicians were reportedly the most common source of information about medications, while the highest-quality information was obtained from pharmacists.

Conclusion: The frequency of home storing of medications was very high in this study. Customers, especially the lower education groups, had very little information about the side effects of drugs and differentiation of OTC and POM medications. Wayward use of antibiotics was very high among the drugstore clients. It seems that the information provided by the pharmacists can be one of the most effective ways for advancing the level of knowledge among the consumers of medications.
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http://dx.doi.org/10.2174/157488609788172982DOI Listing
May 2009